Skin Centre is a globally acknowledged expert in the field of Mohs surgery, but that doesn’t mean we underestimate the personal experience of having any minor or major surgical procedure. This blog piece is our opportunity to allay any concerns you may have, plus tell you a bit more about what a day at the Skin Centre will hold for you.
In case you’re still unsure of what Mohs surgery entails, we'll recap briefly. It’s a microscopically controlled surgical procedure for the excision and treatment of common types of skin cancer. The technique has the distinguishing benefit of having your tissue examined cancer cells after each removal with high accuracy - while you wait. The result of that examination accurately establishes the need for any further tissue removal and has shown a ten-year cure rate of up to 99% in the treatment of basal cell carcinomas, 97% in the treatment of squamous cell carcinomas.
It'll take little more than a click to see you’ve come to the best place in New Zealand to have your Mohs surgery. Skin Centre’s incredibly talented dermatological surgeons are unquestionably among the best in the world, as are our excellent purpose-built facilities.
While this may reassure your initial concerns, we know from thousands of hours at patient’s bedsides undergoing procedures just like yours, that there are many worries you may have but don’t necessarily express. It’s a patient’s right to be as informed as possible, and we want you to come in with the confidence of knowing just what to expect.
With a 7.30 a.m. start and some surgeries not finishing until around 8 or 9 o’clock, it can be a long day, with an average discharge time mid to late afternoon. Due to the nature of the surgery, there can be a considerable element of waiting involved. We make that time as pleasant as possible by providing a gorgeous, serene environment with large, comfortable lazy-boy armchairs, magazines and movies for your ultimate relaxation.
Nonetheless, we are highly aware that anxiety often accompanies this downtime, with the anticipation of your results. In light of this, we make your comfort and happiness the focus of our day. In fact, in staff interviews, they consistently rank “putting their patients at ease” as one of the most rewarding parts of their job. It shows, with everyone from our frontline receptionists to nurses receiving praise and excellent feedback on numerous occasions.
Furthermore, we appreciate that feeling nervous is a reasonable response to this situation. If you think anxiety could potentially make your day more difficult, the best course of action is to mention it to your nurse at the time of your admission. Our empathetic doctors have the option of prescribing a sedative if there's a need.
Following admission, we'll take you through to the theatre where the surgeon administers a local anaesthetic to the area, which takes effect in around 30 minutes. After which, they'll perform a first ‘stage’; meaning they’ll excise a minimum area of tissue for examination.
An experienced dermatologist's eye inspects your skin under a microscope for tracing and removal of the skin cancer including its roots. Each stage takes time to examine thoroughly, looking beyond the visible extent of any a tumour, precisely identifying and removing it while leaving the healthy tissue unharmed. If the margins of your tissue are not clear of cancer cells in the first stage, the surgeon will return to take the second stage.
One of the best things about Mohs is accurately pinpointing any residual tumour cells left in the wound, and only those cells are excised. It's this tissue sparing element of Mohs surgery that sets it apart; the surgeon removes as little skin as possible, so there's more room to achieve the best possible cosmetic repair following the removal of a tumour.
A note on local anaesthetic - Being awake for your surgery may seem intimidating at first, but there are some significant benefits. Firstly, it’s much safer than ‘going under’ a general anaesthetic - there are far fewer medications and resulting side effects. Also, you won’t need to be ‘nil by mouth’ before you come in, which is quite comforting to more than a few of us. What’s more, we provide top-notch catered meals from the iconic Med Cafe in Tauranga, which helps pass the time.
Once your margins are clear, your surgeon will make your final repair. You’ll have a large dressing applied which we'll take down two days later. If you’re an out-of-towner, you'll need to stay overnight. You may need a third visit in 5-7 days (depending on the size of your repair) for the removal of your sutures, but more often than not, the sutures are dissolving. If so, your final visit would be at the six-week mark following your surgery. Please remember, that if you are unsure or concerned at any point during this period, we are only a phone call away.
We are very proud of the incredible repairs completed time and again by our Skin Centre surgeons - beautiful, meticulous and cancer-free closures with outstanding cosmetic results. Even cancers which have previously been unsuccessfully treated by other methods are often curable by Mohs Micrographic Surgery. Click here to see a video clip of one of our patients after her Mohs surgery.